Your Right to Know

As supporters of Medicaid expansion in Ohio grow increasingly impatient with legislative
inaction, talk, both publicly and privately, is turning toward alternatives such as a 2014 ballot
issue.

“In the balance is health care for hundreds of thousands of Ohioans and the jobs that would be
attached to those,” said Anthony Caldwell, spokesman for Service Employees International Union
District 1199.

The SEIU is part of a broader coalition, the Ohio Alliance for Health Transformation, whose
leaders still hope for legislative action before lawmakers pass the two-year budget in late June.
Gov. John Kasich proposed expanding Medicaid to cover about 275,000 Ohioans who earn up to 138
percent of the federal poverty level.

“I don’t know how much longer we can wait to see how the legislature acts,” Caldwell said. “...
It may come to a ballot issue.”

House Republicans pulled Kasich’s plan out of the budget, and Senate President Keith Faber,
R-Celina, has said it will not be put back. However, both House and Senate GOP leaders have
indicated a willingness to work on an alternative to the expansion outside the budget, possibly in
the fall.A few House Republicans are expected to introduce Medicaid bills within the next two
weeks, providing a variety of options.

“If people are talking about launching a ballot initiative, it’s because we are not seeing a
sense of urgency from the speaker or Senate president,” she said. “There are certainly (lawmakers)
working very hard to get this done, but we don’t see it from leadership.”

Faber this week said the Senate is looking to cover more people at a more-effective cost. “We
have some ideas and I think we’re going to have a pathway to victory,” he said.

Expanding Medicaid would bring $13 billion in federal money to Ohio over seven years, but Faber
said he and his colleagues do not trust that the federal government will uphold the deal long
term.

Supporters have been discouraged by Faber and other conservatives who have talked of a
more-limited expansion, possibly just to those in need of mental-health care and drug-addiction
services, and new mandates such as drug testing, work requirements and time limits on benefits. All
would be subject to approval by federal regulators.

Supporters worry that if lawmakers don’t act soon, state officials won’t have time to enact the
plan before Jan. 1, the start of a three-year period when the federal government will pay 100
percent of Medicaid expansion costs. It’s also the date when most Americans must have health care
or pay a penalty under the new federal health-care law.

Despite the frustration, Levine said holding off on a ballot initiative would give lawmakers the
benefit of the doubt and time to finish their work without the distraction. A ballot issue is not
ideal because it would have to wait until 2014, missing at least one year of full federal
funding.

“My fear is that launching before June 30 could give them an excuse not to act,” Levine
said.

Advocates are hosting rallies across the state on Monday, including one in Whitehall, in support
of Medicaid expansion.